Your DIRECT Exchange Address – What exactly is it?

 In Articles, Coding & Documentation, Provider Notes

Now that almost 80% of providers have EHR systems in place, we are rapidly moving toward the time when patient data will be exchanged electronically instead of through paper faxes. In fact, one of the Meaningful Use Stage 2 requirements is that you send data electronically on 10% of your referrals.

In most cases, electronic exchange of data requires you to have a DIRECT Exchange Address. This looks and acts a lot like an email, but comes with a much higher layer of security. The address will include the word ‘direct.’ For example: A provider must apply for a DIRECT Exchange Address from a Health Information Service Provider (HISP), and HISPs may charge a fee, most commonly around $100 per year.

Many EHR systems have a HISP embedded within their product. The vendor may automatically register providers with a HISP and the process may function invisibly so that providers and practices are not even aware of their DIRECT Exchange Address. Think of it like e-prescribing, which sends patient information securely to pharmacies.

Surescripts, the company that most EHRs rely on for e-prescribing, is one popular HISP used by many EHRs. Unfortunately, different EHRs may use different HISPs, and there is no central directory of DIRECT Exchange Addresses. If a provider with whom you exchange data uses an EHR with a different HISP, you will likely need to manually enter the provider’s DIRECT Exchange Address somewhere in your EHR setup files (much like you would enter their fax number).

Our recommendations:

  • Learn about Electronic Exchange and how it works in your EHR. All 2014 certified products must provide this functionality. Though not yet required, some EHRs also provide the capability for you to import discrete data (medication list, problem list, etc.) into your EHR from the data you receive electronically from other providers.
  • Ask your EHR vendor whether you have a DIRECT Exchange Address and what it is. Share it with practices that send you referrals.
  • Ask your EHR vendor about their plans to provide a directory, what HISP they use, and which other EHR programs are linked to that HISP. You may have to call the practice to ask for their DIRECT Exchange Address, however the terminology is not well known and can be confusing. In these early days, you’ll have the most success sending electronic data to EHRs that use the same HISP as your EHR.

Learn more about DIRECT Exchange Addresses here.

For additional assistance with DIRECT Exchange Addresses, contact Jeanne Chamberlin at 919-442-2422 or

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